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SASTS_M3_RECC Intro_QuietLeak

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Created on December 22, 2025

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Transcript

The Quiet Leak

When “post-operative recovery” conceals septic peritonitis

When “post-operative recovery” conceals septic peritonitis

Start

Case ID:

25-LYRA-GI

Name: Lyra Species: Feline | Breed: Domestic Shorthair Sex: Neutered female | Age: 10 years Weight: 3.8 Kg Reason for consultation: Lyra died 10 days after intestinal surgery. At emergency re-presentation she was in shock. Post-mortem identified anastomotic dehiscence with diffuse septic peritonitis.

Next

The Recovery That Looked “Good Enough”

3–4 weeks of intermittent vomiting, weight loss and reduced appetite; a discrete abdominal mass was suspected on examination and ultrasound.

Exploratory laparotomy and enterectomy were performed; intraoperative notes described mildly turbid effusion and enlarged mesenteric lymph nodes, but sampling was not completed.

Next

The Recovery That Looked “Good Enough”

Post-operatively, Lyra had persistent hyporexia and intermittent abdominal pain that temporarily improved with antibiotics, NSAIDs and appetite stimulation; she deteriorated and died on day 10 with confirmed septic peritonitis.

Next

The Day the Story

Should Have Changed

The data that should have triggered an “abdomen-first” safety pathway:

What happened after surgery:

Ongoing lethargy and poor appetite were treated symptomatically Clinical reassessment and confirmatory testing for peritonitis were delayed. Cat re-presented in shock; anastomotic dehiscence and diffuse septic peritonitis

Pre- and peri-operative evidence consistent with evolving peritonitis (abdominal effusion / mesenteric reaction ± turbid fluid), followed by persistent post-operative systemic illness that did not fit uncomplicated recovery.

Next

Investigate with:

Ive Watson

Mission

Determine the three critical control points that led to a fatal outcome following surgery for an intestinal mass in a cat.

Approach

Work backwards from the death on day 10. Identify where risk signals were present, what information was missing, and what a safer staged plan would have looked like in theatre and during post-operative monitoring.

Start the investigation

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